Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREWDRIVER T15 CANN COMP SR

Facility

$2,618.20

Service Code	HCPCS C1713
Hospital Charge Code	270693426
Hospital Revenue Code	278
Min. Negotiated Rate	$392.73
Max. Negotiated Rate	$633.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$523.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$633.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$576.00
Rate for Payer: Qualcare PPO/HMO/WC	$392.73

SCREWDRIVER T15 CANN COMP SR

Facility

$2,618.20

Service Code	HCPCS C1713
Hospital Charge Code	270693426
Hospital Revenue Code	278
Min. Negotiated Rate	$63.10
Max. Negotiated Rate	$1,309.10
Rate for Payer: Aetna Commercial	$994.92
Rate for Payer: Aetna Medicare Advantage	$785.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$667.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$667.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$523.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$667.64
Rate for Payer: Cigna Commercial	$1,309.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$633.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$576.00
Rate for Payer: Qualcare PPO/HMO/WC	$392.73
Rate for Payer: UnitedHealthcare Community & State	$63.10
Rate for Payer: Wellpoint Medicaid Managed Care	$69.38

SCREWDRIVER T25 3.5

Facility

$3,975.00

Hospital Charge Code	270692386
Hospital Revenue Code	272
Min. Negotiated Rate	$596.25
Max. Negotiated Rate	$596.25
Rate for Payer: Qualcare PPO/HMO/WC	$596.25

SCREWDRIVER T25 3.5

Facility

$3,975.00

Hospital Charge Code	270692386
Hospital Revenue Code	272
Min. Negotiated Rate	$95.80
Max. Negotiated Rate	$1,987.50
Rate for Payer: Aetna Commercial	$1,510.50
Rate for Payer: Aetna Medicare Advantage	$1,192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,013.62
Rate for Payer: Cigna Commercial	$1,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,192.50
Rate for Payer: Oxford Commercial	$795.00
Rate for Payer: Qualcare PPO/HMO/WC	$596.25
Rate for Payer: UnitedHealthcare Commercial	$795.00
Rate for Payer: UnitedHealthcare Community & State	$95.80
Rate for Payer: Wellpoint Medicaid Managed Care	$105.34

SCREWDRIVER T40 277 MM

Facility

$4,364.15

Hospital Charge Code	270691507
Hospital Revenue Code	272
Min. Negotiated Rate	$105.18
Max. Negotiated Rate	$2,182.07
Rate for Payer: Aetna Commercial	$1,658.38
Rate for Payer: Aetna Medicare Advantage	$1,309.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,112.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,112.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,112.86
Rate for Payer: Cigna Commercial	$2,182.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,309.24
Rate for Payer: Oxford Commercial	$872.83
Rate for Payer: Qualcare PPO/HMO/WC	$654.62
Rate for Payer: UnitedHealthcare Commercial	$872.83
Rate for Payer: UnitedHealthcare Community & State	$105.18
Rate for Payer: Wellpoint Medicaid Managed Care	$115.65

SCREWDRIVER T40 277 MM

Facility

$4,364.15

Hospital Charge Code	270691507
Hospital Revenue Code	272
Min. Negotiated Rate	$654.62
Max. Negotiated Rate	$654.62
Rate for Payer: Qualcare PPO/HMO/WC	$654.62

SCREWDRIVER TAKEHOME BMT 72330

Facility

$1,080.85

Hospital Charge Code	270616769
Hospital Revenue Code	272
Min. Negotiated Rate	$162.13
Max. Negotiated Rate	$162.13
Rate for Payer: Qualcare PPO/HMO/WC	$162.13

SCREWDRIVER TAKEHOME BMT 72330

Facility

$1,080.85

Hospital Charge Code	270616769
Hospital Revenue Code	272
Min. Negotiated Rate	$26.05
Max. Negotiated Rate	$540.42
Rate for Payer: Aetna Commercial	$410.72
Rate for Payer: Aetna Medicare Advantage	$324.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$275.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$275.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$275.62
Rate for Payer: Cigna Commercial	$540.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$324.25
Rate for Payer: Oxford Commercial	$216.17
Rate for Payer: Qualcare PPO/HMO/WC	$162.13
Rate for Payer: UnitedHealthcare Commercial	$216.17
Rate for Payer: UnitedHealthcare Community & State	$26.05
Rate for Payer: Wellpoint Medicaid Managed Care	$28.64

SCREW D/THRD TI 2.0x22mm

Facility

$1,125.00

Hospital Charge Code	270669704
Hospital Revenue Code	278
Min. Negotiated Rate	$27.11
Max. Negotiated Rate	$562.50
Rate for Payer: Aetna Commercial	$427.50
Rate for Payer: Aetna Medicare Advantage	$337.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.88
Rate for Payer: Cigna Commercial	$562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$247.50
Rate for Payer: Qualcare PPO/HMO/WC	$168.75
Rate for Payer: UnitedHealthcare Community & State	$27.11
Rate for Payer: Wellpoint Medicaid Managed Care	$29.81

SCREW D/THRD TI 2.0x22mm

Facility

$1,125.00

Hospital Charge Code	270669704
Hospital Revenue Code	278
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$272.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$247.50
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

SCREW D/THRD TI 2.0x24mm

Facility

$1,125.00

Hospital Charge Code	270669878
Hospital Revenue Code	278
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$272.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$247.50
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

SCREW D/THRD TI 2.0x24mm

Facility

$1,125.00

Hospital Charge Code	270669878
Hospital Revenue Code	278
Min. Negotiated Rate	$27.11
Max. Negotiated Rate	$562.50
Rate for Payer: Aetna Commercial	$427.50
Rate for Payer: Aetna Medicare Advantage	$337.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.88
Rate for Payer: Cigna Commercial	$562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$247.50
Rate for Payer: Qualcare PPO/HMO/WC	$168.75
Rate for Payer: UnitedHealthcare Community & State	$27.11
Rate for Payer: Wellpoint Medicaid Managed Care	$29.81

SCREW D/THRD TI 2.0x26mm

Facility

$1,325.00

Hospital Charge Code	270669703
Hospital Revenue Code	278
Min. Negotiated Rate	$31.93
Max. Negotiated Rate	$662.50
Rate for Payer: Aetna Commercial	$503.50
Rate for Payer: Aetna Medicare Advantage	$397.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$337.88
Rate for Payer: Cigna Commercial	$662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$291.50
Rate for Payer: Qualcare PPO/HMO/WC	$198.75
Rate for Payer: UnitedHealthcare Community & State	$31.93
Rate for Payer: Wellpoint Medicaid Managed Care	$35.11

SCREW D/THRD TI 2.0x26mm

Facility

$1,325.00

Hospital Charge Code	270669703
Hospital Revenue Code	278
Min. Negotiated Rate	$198.75
Max. Negotiated Rate	$320.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$291.50
Rate for Payer: Qualcare PPO/HMO/WC	$198.75

SCREW D/THRD TI 3.0x14mm

Facility

$1,325.00

Hospital Charge Code	270669702
Hospital Revenue Code	278
Min. Negotiated Rate	$31.93
Max. Negotiated Rate	$662.50
Rate for Payer: Aetna Commercial	$503.50
Rate for Payer: Aetna Medicare Advantage	$397.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$337.88
Rate for Payer: Cigna Commercial	$662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$291.50
Rate for Payer: Qualcare PPO/HMO/WC	$198.75
Rate for Payer: UnitedHealthcare Community & State	$31.93
Rate for Payer: Wellpoint Medicaid Managed Care	$35.11

SCREW D/THRD TI 3.0x14mm

Facility

$1,325.00

Hospital Charge Code	270669702
Hospital Revenue Code	278
Min. Negotiated Rate	$198.75
Max. Negotiated Rate	$320.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$291.50
Rate for Payer: Qualcare PPO/HMO/WC	$198.75

SCREW D/THRD TI 3.0x30mm

Facility

$1,325.00

Hospital Charge Code	270669879
Hospital Revenue Code	278
Min. Negotiated Rate	$198.75
Max. Negotiated Rate	$320.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$291.50
Rate for Payer: Qualcare PPO/HMO/WC	$198.75

SCREW D/THRD TI 3.0x30mm

Facility

$1,325.00

Hospital Charge Code	270669879
Hospital Revenue Code	278
Min. Negotiated Rate	$31.93
Max. Negotiated Rate	$662.50
Rate for Payer: Aetna Commercial	$503.50
Rate for Payer: Aetna Medicare Advantage	$397.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$337.88
Rate for Payer: Cigna Commercial	$662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$291.50
Rate for Payer: Qualcare PPO/HMO/WC	$198.75
Rate for Payer: UnitedHealthcare Community & State	$31.93
Rate for Payer: Wellpoint Medicaid Managed Care	$35.11

SCREW D/THRD TI 3.0x34mm

Facility

$1,325.00

Hospital Charge Code	270669880
Hospital Revenue Code	278
Min. Negotiated Rate	$198.75
Max. Negotiated Rate	$320.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$291.50
Rate for Payer: Qualcare PPO/HMO/WC	$198.75

SCREW D/THRD TI 3.0x34mm

Facility

$1,325.00

Hospital Charge Code	270669880
Hospital Revenue Code	278
Min. Negotiated Rate	$31.93
Max. Negotiated Rate	$662.50
Rate for Payer: Aetna Commercial	$503.50
Rate for Payer: Aetna Medicare Advantage	$397.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$337.88
Rate for Payer: Cigna Commercial	$662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$291.50
Rate for Payer: Qualcare PPO/HMO/WC	$198.75
Rate for Payer: UnitedHealthcare Community & State	$31.93
Rate for Payer: Wellpoint Medicaid Managed Care	$35.11

SCREW D/THRD TI 3.0x38mm

Facility

$1,475.00

Hospital Charge Code	270670788
Hospital Revenue Code	278
Min. Negotiated Rate	$35.55
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$560.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$324.50
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Community & State	$35.55
Rate for Payer: Wellpoint Medicaid Managed Care	$39.09

SCREW D/THRD TI 3.0x38mm

Facility

$1,475.00

Hospital Charge Code	270670788
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$356.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$324.50
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

SCREWE BONE FUL THD 2.4 X 26MM

Facility

$770.85

Service Code	HCPCS C1713
Hospital Charge Code	270705670
Hospital Revenue Code	278
Min. Negotiated Rate	$18.58
Max. Negotiated Rate	$385.43
Rate for Payer: Aetna Commercial	$292.92
Rate for Payer: Aetna Medicare Advantage	$231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$196.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$196.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$154.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$196.57
Rate for Payer: Cigna Commercial	$385.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$186.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$169.59
Rate for Payer: Qualcare PPO/HMO/WC	$115.63
Rate for Payer: UnitedHealthcare Community & State	$18.58
Rate for Payer: Wellpoint Medicaid Managed Care	$20.43

SCREWE BONE FUL THD 2.4 X 26MM

Facility

$770.85

Service Code	HCPCS C1713
Hospital Charge Code	270705670
Hospital Revenue Code	278
Min. Negotiated Rate	$115.63
Max. Negotiated Rate	$186.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$154.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$186.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$169.59
Rate for Payer: Qualcare PPO/HMO/WC	$115.63

SCREW ECT 4.5 SLF TP 16-64MM**

Facility

$51.00

Hospital Charge Code	1605674
Hospital Revenue Code	274
Min. Negotiated Rate	$7.65
Max. Negotiated Rate	$12.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$11.22
Rate for Payer: Qualcare PPO/HMO/WC	$7.65

Know your out-of-pocket cost for care.

All Charges